| NPI | 1336334317 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 3798)  | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NE P-754)  | 
| 101YM0800X Counselor, Mental Health (Licence: NE 8444)  | |
| Enumeration Date | 2007-09-12 | 
| Last Update Date | 2024-07-16 |