| NPI | 1457361875 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VT 103454) | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VT 000141) | 
| 101YM0800X Counselor, Mental Health (Licence: VT 089-000443) | |
| Enumeration Date | 2006-08-08 | 
| Last Update Date | 2025-09-11 |