| NPI | 1407888274 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MD 93405)  | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MD LCA451)  | 
| 101YM0800X Counselor, Mental Health (Licence: MD LC2284)  | |
| Enumeration Date | 2006-07-06 | 
| Last Update Date | 2024-04-23 |