| NPI | 1487018453 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NC A12165) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NC A12165) |
| 101YP2500X Counselor Professional (Licence: NC A12165) | |
| Enumeration Date | 2016-04-06 |
| Last Update Date | 2016-04-06 |