| NPI | 1528592284 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OR C6980) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 05-24-20422) |
| Enumeration Date | 2017-04-19 |
| Last Update Date | 2025-12-03 |