| NPI | 1609034016 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AK 500) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: AK 500) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AK 3270) | |
| Enumeration Date | 2008-06-02 |
| Last Update Date | 2008-06-02 |