NPI | 1619211158 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO LPC.0011401) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CO LPC.0011401) |
101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ACD.000837) | |
Enumeration Date | 2012-11-21 |
Last Update Date | 2024-11-20 |