| NPI | 1588639652 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: SC 4056) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: SC 4056) |
| 101YP2500X Counselor, Professional (Licence: SC 4056) | |
| 106H00000X Marriage & Family Therapist (Licence: SC 4056) | |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2015-09-29 |