| NPI | 1336493592 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: VA 0701008612) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH13881) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| Enumeration Date | 2012-11-08 |
| Last Update Date | 2022-01-20 |