| NPI | 1639456916 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC 8607) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NC 00113626) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 2874-A) | |
| 101YM0800X Counselor, Mental Health (Licence: NC 8607) | |
| Enumeration Date | 2011-11-14 |
| Last Update Date | 2013-07-25 |