| NPI | 1639667611 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MD LC17807) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: VA 0701015474) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: DE 1718) | |
| Enumeration Date | 2018-04-25 |
| Last Update Date | 2026-04-24 |