| NPI | 1467009415 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MT LCPC-LIC-52379) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MT BBH-LAC-LIC-38099) |
| Enumeration Date | 2019-08-23 |
| Last Update Date | 2022-03-30 |