| NPI | 1306237367 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180.008753) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: IL 180.008753) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 30510) | |
| 101YM0800X Counselor, Mental Health (Licence: IL 180.008753) | |
| 106H00000X Marriage & Family Therapist (Licence: IL 180-008753) | |
| Enumeration Date | 2015-02-12 |
| Last Update Date | 2015-02-12 |