| NPI | 1518362219 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: LA 3926) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: LA 1049) |
| 101YM0800X Counselor, Mental Health (Licence: LA 3926) | |
| Enumeration Date | 2014-10-24 |
| Last Update Date | 2016-10-13 |