| NPI | 1447435920 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NE 1776) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NE 3303) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NE 872) | |
| Enumeration Date | 2008-01-03 |
| Last Update Date | 2022-07-21 |