| NPI | 1588178537 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IA 095696) |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: IA 1619054335) |
| Enumeration Date | 2017-11-29 |
| Last Update Date | 2023-07-14 |