| NPI | 1497050207 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: WI 7275) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MN 302964) |
| Enumeration Date | 2011-01-26 |
| Last Update Date | 2022-07-21 |