| NPI | 1417609017 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MT BBH-LCPC-LIC-72320) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: IL 178016895) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 36744) | |
| Enumeration Date | 2022-01-25 |
| Last Update Date | 2025-02-20 |