| NPI | 1477564805 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MD LCO313) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MD LCA326) |
| 101YM0800X Counselor, Mental Health (Licence: MD LC0313) | |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2023-11-20 |