| NPI | 1376085183 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: FL IMH19971) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: FL IMH19971) |
| Enumeration Date | 2016-11-09 |
| Last Update Date | 2021-07-13 |