| NPI | 1649218041 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MI 6451023777) | 
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MI 6451023777) | 
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI 2-00633) | |
| Enumeration Date | 2006-06-04 | 
| Last Update Date | 2024-12-03 |