| NPI | 1508317462 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: VT 068.0057666) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: VT 151.0124715) |
| Enumeration Date | 2016-10-16 |
| Last Update Date | 2016-10-16 |