| NPI | 1669866208 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC 11450) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NC 11450) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 21996) | |
| Enumeration Date | 2015-03-21 |
| Last Update Date | 2018-10-05 |