NPI | 1376990887 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC 12065) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 21906) |
101YM0800X Counselor, Mental Health (Licence: VT 068.0135520TELE) | |
Enumeration Date | 2016-05-16 |
Last Update Date | 2025-07-02 |