| NPI | 1548486772 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OK 1894)  | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OK 468)  | 
| Enumeration Date | 2007-04-17 | 
| Last Update Date | 2025-09-11 |