| NPI | 1649644568 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MI 6401015059) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI L944208) |
| 101YM0800X Counselor, Mental Health (Licence: MI 6401015059) | |
| Enumeration Date | 2015-11-16 |
| Last Update Date | 2018-09-18 |