| NPI | 1548505092 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC S9848) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC CCS-21665) | |
| Enumeration Date | 2012-12-10 |
| Last Update Date | 2024-07-22 |