| NPI | 1659678225 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 1756) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NC S9254) |
| 101YM0800X Counselor, Mental Health (Licence: NC S9254) | |
| Enumeration Date | 2011-02-17 |
| Last Update Date | 2022-01-25 |