| NPI | 1326584608 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MT MT LCPC 1225) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MT 1225 LCPC) |
| 101YM0800X Counselor, Mental Health (Licence: MT 1225 LCPC) | |
| 101YP2500X Counselor, Professional (Licence: MT 1225 LCPC) | |
| Enumeration Date | 2017-01-11 |
| Last Update Date | 2017-03-14 |