| NPI | 1457131948 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MT 63194) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 306543) |
| 101YM0800X Counselor, Mental Health (Licence: MT 64741) | |
| Enumeration Date | 2023-10-02 |
| Last Update Date | 2023-10-02 |