| NPI | 1386783793 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC 13112) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY 000799) |
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: NC LCAS) | |
| 103TC1900X Psychologist, Counseling (Licence: NY LMHC) | |
| 103TC1900X Psychologist, Counseling (Licence: NC LPC) | |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2019-06-04 |