| NPI | 1568627875 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OR C2376) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: OR C2376) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 06-11-70) | |
| Enumeration Date | 2008-07-25 |
| Last Update Date | 2023-05-19 |