| NPI | 1568966190 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NC LCAS-22268) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NC 12229) |
| Enumeration Date | 2018-03-20 |
| Last Update Date | 2021-07-12 |