| NPI | 1558817759 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NE 2540) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NE P-1105) |
| Enumeration Date | 2016-08-28 |
| Last Update Date | 2021-01-28 |