| NPI | 1548945728 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225C00000X Rehabilitation Counselor (Licence: CRC00110219) | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI LPC6401011244) | 
| 101YM0800X Counselor, Mental Health (Licence: MI LPC6401011244) | |
| 106H00000X Marriage & Family Therapist (Licence: MI LPC6401011244) | |
| Enumeration Date | 2023-06-16 | 
| Last Update Date | 2023-06-16 |