| NPI | 1376828707 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC 9063) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 20086) |
| 101YM0800X Counselor, Mental Health (Licence: SC 7102) | |
| Enumeration Date | 2011-10-17 |
| Last Update Date | 2019-03-13 |