| NPI | 1578640314 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO 2480) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 2312) |
| 101YP2500X Counselor, Professional (Licence: NE 1284) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO 5543) | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2012-11-19 |