| NPI | 1609247022 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH 12931) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL 5056) |
| 101YP2500X Counselor, Professional (Licence: MN 01674) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 302576) | |
| Enumeration Date | 2015-10-12 |
| Last Update Date | 2016-11-18 |