| NPI | 1639692742 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC 12873) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 23491) |
| 101YM0800X Counselor, Mental Health (Licence: NC 12873) | |
| Enumeration Date | 2017-07-20 |
| Last Update Date | 2023-11-02 |