| NPI | 1508024837 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC 10136) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NY 24183) |
| 101YM0800X Counselor, Mental Health (Licence: NY 004906) | |
| Enumeration Date | 2008-05-22 |
| Last Update Date | 2022-04-14 |