| NPI | 1326683541 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: WI 10202-125) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WI 19016-130) |
| Enumeration Date | 2019-11-12 |
| Last Update Date | 2023-02-15 |