| NPI | 1386771277 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MA 1109AL) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MA 258) |
| 101YM0800X Counselor, Mental Health (Licence: MA 4912) | |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2025-09-11 |