| NPI | 1508365495 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL 13402) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: FL 13402) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL 13402) | |
| Enumeration Date | 2018-02-06 |
| Last Update Date | 2021-02-12 |