| NPI | 1457086423 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CT 006098)  | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CT 001454)  | 
| 101YM0800X Counselor, Mental Health (Licence: CT 004976)  | |
| Enumeration Date | 2022-07-22 | 
| Last Update Date | 2024-07-04 |