| NPI | 1508053356 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: AL LPC2523) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: AL 1122) |
| 101YM0800X Counselor Mental Health (Licence: GA LPC002948) | |
| Enumeration Date | 2007-09-25 |
| Last Update Date | 2007-09-25 |