| NPI | 1558475707 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: VA 0701004497) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: TX 5153) |
| 101YM0800X Counselor Mental Health (Licence: TX 13557) | |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2023-03-05 |