| NPI | 1568776763 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: SD LPC7086) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: SD 213035 NCC) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: SD 05111242) | |
| Enumeration Date | 2010-07-29 |
| Last Update Date | 2016-02-05 |