| NPI | 1528325347 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: SD LPC-MH2260) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: SD 6091) |
| 101YM0800X Counselor Mental Health (Licence: SD LPC7191) | |
| Enumeration Date | 2012-04-18 |
| Last Update Date | 2022-10-12 |