| NPI | 1629471693 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC 16704) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WI 2348-226) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 15862-132) | |
| Enumeration Date | 2014-10-03 |
| Last Update Date | 2021-10-29 |