| NPI | 1619374071 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MD LC2191) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MD AD1677) |
| 101YM0800X Counselor Mental Health (Licence: LC2191) | |
| Enumeration Date | 2014-12-01 |
| Last Update Date | 2023-07-21 |