| NPI | 1619317237 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: SD LPC-MH2273) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: SD 6604) |
| 101YP2500X Counselor, Professional (Licence: SD LPC7221) | |
| Enumeration Date | 2013-06-27 |
| Last Update Date | 2020-03-05 |