| NPI | 1598139354 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: FL MH10830) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: FL MH10830) |
| 101YP2500X Counselor Professional (Licence: FL MH10830) | |
| Enumeration Date | 2015-11-17 |
| Last Update Date | 2015-11-17 |