| NPI | 1578116372 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: 27285) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: C-2169) |
| 101YP2500X Counselor, Professional (Licence: 27285) | |
| Enumeration Date | 2019-07-20 |
| Last Update Date | 2019-07-20 |