| NPI | 1619211158 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CO lpc.0011401) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ACD.000837) |
| 101YP2500X Counselor, Professional (Licence: CO LPC.0011401) | |
| Enumeration Date | 2012-11-21 |
| Last Update Date | 2023-05-24 |