| NPI | 1679169510 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CT 2450) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CT 985) |
| 101YP2500X Counselor, Professional (Licence: NJ 37PC00639900) | |
| 101YP2500X Counselor, Professional (Licence: NY 008316-1) | |
| Enumeration Date | 2020-12-15 |
| Last Update Date | 2020-12-15 |