| NPI | 1649315722 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: CO LPC.0004131) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO ACC.0006991) |
| 101YM0800X Counselor, Mental Health (Licence: CO 203172062) | |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2024-02-28 |