| NPI | 1588067342 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: SD LPGMH2249) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: SD 12091546) |
| Enumeration Date | 2014-10-07 |
| Last Update Date | 2020-03-20 |