| NPI | 1598240442 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: CA 109014) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CA LR02760517) |
| Enumeration Date | 2018-09-26 |
| Last Update Date | 2018-09-26 |