| NPI | 1679911218 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OR C4492) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL 5744) |
| 101YM0800X Counselor, Mental Health (Licence: FL IMH9154) | |
| Enumeration Date | 2013-06-05 |
| Last Update Date | 2020-07-20 |