NPI | 1609233717 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH11270) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL MH11270) |
101YP2500X Counselor, Professional (Licence: FL LMHC11270) | |
Enumeration Date | 2016-01-20 |
Last Update Date | 2019-05-21 |