| NPI | 1457652786 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: SC 6428) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NC 10595) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NC 507780) | |
| Enumeration Date | 2010-11-03 |
| Last Update Date | 2017-02-23 |