| NPI | 1457719148 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC 12076)  | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC LCAS-22714)  | 
| 101YM0800X Counselor, Mental Health (Licence: NC A12076)  | |
| Enumeration Date | 2016-02-09 | 
| Last Update Date | 2025-10-14 |