| NPI | 1669561080 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: IL 180-005694) |
| Additional Taxonomies | 103TC1900X Psychologist Counseling (Licence: IL 180-005694) |
| 101Y00000X Counselor (Licence: IL 180-005694) | |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: IL 22217) | |
| 101YM0800X Counselor Mental Health (Licence: IL 180-005694) | |
| 103T00000X Psychologist (Licence: IL 180-005694) | |
| 103TA0400X Psychologist Addiction (Substance Use Disorder) (Licence: IL 180-005694) | |
| 103TB0200X Psychologist Cognitive & Behavioral (Licence: IL 180-005694) | |
| 103TF0000X Psychologist Family (Licence: IL 180-005694) | |
| 171M00000X Case Manager/Care Coordinator (Licence: IL 180-005694) | |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2018-06-28 |