| NPI | 1629513320 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OR R4625) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 18-04-13) |
| Enumeration Date | 2017-01-04 |
| Last Update Date | 2020-05-27 |