| NPI | 1629306626 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) | 
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) | |
| Enumeration Date | 2009-12-02 | 
| Last Update Date | 2025-08-14 |