| NPI | 1437868189 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MT BBH-LCPC-LIC-72310) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MT BBH-LAC-LIC-71150) |
| 101YP2500X Counselor, Professional (Licence: MN 2983) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 306290) | |
| Enumeration Date | 2022-11-22 |
| Last Update Date | 2024-11-13 |