| NPI | 1508070020 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WY 870) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WY 288) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MT 1119) | |
| 101YP2500X Counselor, Professional (Licence: WY 870) | |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2022-07-21 |