| NPI | 1639204514 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 299) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NE 312) |
| 101YM0800X Counselor, Mental Health (Licence: NE 337) | |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2024-07-18 |