| NPI | 1366186348 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MT 62894) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MT 30312) |
| Enumeration Date | 2022-04-25 |
| Last Update Date | 2025-06-03 |