| NPI | 1336563907 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WI 5850-125) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 17091-130) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 16321-132) | |
| Enumeration Date | 2014-02-18 |
| Last Update Date | 2021-11-04 |