| NPI | 1508253741 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MD LC5747) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MD LC5747) |
| 101YM0800X Counselor, Mental Health (Licence: MD LC5747) | |
| Enumeration Date | 2015-04-24 |
| Last Update Date | 2015-04-24 |