| NPI | 1518029917 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: LPCMH2127) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: SD 9607791) |
| 101YP2500X Counselor, Professional (Licence: SD LPC-MH2127) | |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2024-03-20 |