| NPI | 1609156488 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WI 6107-125) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: OR C3948) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2011-08-24 |
| Last Update Date | 2016-09-21 |