| NPI | 1669601589 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: SD LPC-MH 2164) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: SD 06111291) |
| Enumeration Date | 2009-07-13 |
| Last Update Date | 2024-01-11 |