NPI | 1689095929 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO LPC.0012439) |
Additional Taxonomies | 101Y00000X Counselor (Licence: CO LPC.0012439) |
101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO ACD.0000652) | |
Enumeration Date | 2014-01-03 |
Last Update Date | 2021-09-20 |