| NPI | 1669527867 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 5501) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VT 000332) |
| 101YM0800X Counselor, Mental Health (Licence: VT 068-0000434) | |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2008-06-18 |