| NPI | 1538484142 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: IL 180.004894) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: IL 180.004894) |
| Enumeration Date | 2010-04-07 |
| Last Update Date | 2023-10-06 |