| NPI | 1578392320 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health | 
| Additional Taxonomies | 101Y00000X Counselor | 
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| Enumeration Date | 2024-07-30 | 
| Last Update Date | 2024-07-30 |