| NPI | 1508429614 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: GA LPC010879) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: GA LPC010879) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: GA LPC010879) | |
| Enumeration Date | 2019-04-16 |
| Last Update Date | 2019-04-16 |