| NPI | 1336639574 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC LCASA-24821) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC 13484) |
| 101YP2500X Counselor, Professional (Licence: NC A13484) | |
| Enumeration Date | 2018-05-14 |
| Last Update Date | 2023-02-03 |