| NPI | 1538499603 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: FL 19130) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: FL 3358) |
| 101Y00000X Counselor (Licence: FL 4059) | |
| Enumeration Date | 2010-01-12 |
| Last Update Date | 2023-03-09 |