| NPI | 1417268178 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 1085) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 4087) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NE 997) | |
| Enumeration Date | 2010-06-28 |
| Last Update Date | 2014-01-22 |