| NPI | 1649624180 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI 6401016117) |
| Additional Taxonomies | 101YS0200X Counselor, School (Licence: MI 6401016117) |
| 101YM0800X Counselor, Mental Health (Licence: MI 6401016117) | |
| Enumeration Date | 2016-04-21 |
| Last Update Date | 2017-10-30 |