| NPI | 1497147227 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MD LC7943) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 304007) |
| 101YM0800X Counselor, Mental Health (Licence: MN 953) | |
| Enumeration Date | 2015-03-03 |
| Last Update Date | 2024-10-01 |