| NPI | 1528614757 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AZ LPC-08043) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WI 8796-125) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 17085-132) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ LAAC-15558) | |
| Enumeration Date | 2019-08-13 |
| Last Update Date | 2024-10-15 |