| NPI | 1558779298 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC LCAS-21440) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 252Y00000X Early Intervention Provider Agency | |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2014-07-25 |
| Last Update Date | 2021-01-08 |