| NPI | 1609166115 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180003528) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: IL 19943) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 15725) | |
| 101YM0800X Counselor, Mental Health (Licence: IL 178000692) | |
| Enumeration Date | 2011-04-18 |
| Last Update Date | 2015-02-16 |