NPI | 1326453341 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CO LPC.0016166) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO 0001280) |
Enumeration Date | 2014-06-27 |
Last Update Date | 2020-04-14 |