| NPI | 1649787110 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 2900) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NE 11525) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NE P1562) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NE 1411) | |
| Enumeration Date | 2018-01-05 |
| Last Update Date | 2022-05-12 |