NPI | 1598028185 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: VT 068.0057799) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VT 000508) |
Enumeration Date | 2012-06-19 |
Last Update Date | 2024-01-10 |