| NPI | 1679021133 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 133N00000X Nutritionist | |
| 171W00000X Contractor | |
| Enumeration Date | 2016-09-13 |
| Last Update Date | 2022-08-15 |