| NPI | 1457815359 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MT BBH-SWLC-LIC-71187) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MT BBH-LAC-LIC-37003) |
| Enumeration Date | 2019-01-24 |
| Last Update Date | 2024-08-08 |