| NPI | 1336418961 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC 10180) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC A10180) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| Enumeration Date | 2011-12-28 |
| Last Update Date | 2020-04-22 |