| NPI | 1649671421 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: WI 5139-125) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WI 1764-130) |
| 101YM0800X Counselor Mental Health (Licence: WI 5139-125) | |
| Enumeration Date | 2014-09-11 |
| Last Update Date | 2024-03-19 |