| NPI | 1679034516 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: UT 6086382-3501) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: UT 6086382-6005) |
| Enumeration Date | 2019-03-25 |
| Last Update Date | 2020-05-01 |