| NPI | 1679879753 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NE 11554) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NE P-1610) |
| Enumeration Date | 2011-02-07 |
| Last Update Date | 2021-08-27 |