| NPI | 1598241135 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OR R6346) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 22-01-10316) |
| Enumeration Date | 2018-07-17 |
| Last Update Date | 2022-07-13 |