| NPI | 1417294133 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: SD LPC-MH2289) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: SD 12091537) |
| Enumeration Date | 2013-01-15 |
| Last Update Date | 2019-03-05 |