NPI | 1376913475 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MO 2014042825) |
Additional Taxonomies | 101Y00000X Counselor (Licence: MO 2014042825) |
101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MO 2014042825) | |
101YM0800X Counselor, Mental Health (Licence: MO 2014042825) | |
Enumeration Date | 2015-10-01 |
Last Update Date | 2020-05-22 |