| NPI | 1417323114 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: WI 6539-125) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: WI 2854-226) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WI 16069-132) | |
| Enumeration Date | 2015-08-17 |
| Last Update Date | 2018-03-17 |