| NPI | 1609166032 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MD LC5992) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MD AD1793) |
| 101YP2500X Counselor, Professional (Licence: MD LC5992) | |
| Enumeration Date | 2011-04-19 |
| Last Update Date | 2024-01-22 |