| NPI | 1467807172 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NC 10862) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NC A10862) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) | |
| Enumeration Date | 2016-05-01 |
| Last Update Date | 2020-01-22 |