| NPI | 1679002596 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC 10973) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 20627) |
| 101YM0800X Counselor, Mental Health (Licence: NC 10973) | |
| Enumeration Date | 2017-06-05 |
| Last Update Date | 2018-08-07 |