| NPI | 1487994760 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MI 6401013628) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301015404) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI 6401013628) | |
| Enumeration Date | 2013-02-22 |
| Last Update Date | 2024-06-07 |