| NPI | 1518269505 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: KS 2475) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: KS 2156) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KS 191) | |
| Enumeration Date | 2010-11-23 |
| Last Update Date | 2017-03-23 |