| NPI | 1538787502 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: SC 11370) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: SC 8685) | 
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: SC ADC-2085) | |
| Enumeration Date | 2020-07-07 | 
| Last Update Date | 2025-09-08 |