| NPI | 1639544695 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: TX 84799) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OH 141211) |
| 101YP2500X Counselor Professional (Licence: OH C.1700631) | |
| Enumeration Date | 2015-12-02 |
| Last Update Date | 2022-07-26 |