| NPI | 1578953709 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 1713) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 4914) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NE P-1279) | |
| Enumeration Date | 2015-01-26 |
| Last Update Date | 2017-02-27 |