| NPI | 1558775957 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: CO LPC.0012966) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CO NLC.0104285) |
| 101YM0800X Counselor Mental Health (Licence: CO NLC.0104285) | |
| Enumeration Date | 2014-06-13 |
| Last Update Date | 2021-01-21 |