NPI | 1649902321 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MT BBH-LCPC-LIC-70084) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MT BBH-LAC-LIC-50154) |
Enumeration Date | 2022-06-30 |
Last Update Date | 2024-12-18 |