| NPI | 1679665590 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC 5123) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 5123) |
| 101YM0800X Counselor, Mental Health (Licence: NC 5123) | |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2014-11-18 |