NPI | 1326508755 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CO LPC.0014212) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO ACD.0001204) |
Enumeration Date | 2019-03-21 |
Last Update Date | 2023-08-15 |