| NPI | 1467512392 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MT 1157) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MT 1157) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MT 944) | |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2025-02-08 |