| NPI | 1548604978 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: AK PCOP912) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: AZ 13157) |
| 101YM0800X Counselor Mental Health (Licence: AZ 13613) | |
| Enumeration Date | 2013-04-29 |
| Last Update Date | 2019-03-06 |