| NPI | 1598167058 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MI 6401001629) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MI C-00971) |
| 101YP2500X Counselor Professional (Licence: MI 6401001629) | |
| Enumeration Date | 2014-09-16 |
| Last Update Date | 2024-06-27 |