| NPI | 1669931226 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MD LC10959) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MD AC3123) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: TX 44846) | |
| 101YP2500X Counselor Professional (Licence: TX 87418) | |
| 101YP2500X Counselor Professional (Licence: MI 6401222375) | |
| Enumeration Date | 2019-03-13 |
| Last Update Date | 2024-04-19 |