NPI | 1578960779 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NM 0169661) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NM 0165411) |
101YM0800X Counselor, Mental Health (Licence: NM CCMH0191461) | |
Enumeration Date | 2014-12-03 |
Last Update Date | 2018-12-05 |