| NPI | 1689197741 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: LC7983) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MD LC7983) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 101YM0800X Counselor, Mental Health (Licence: MD LC7983) | |
| 101YM0800X Counselor, Mental Health | |
| 101YP2500X Counselor, Professional (Licence: MD ATC121) | |
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2017-07-20 |
| Last Update Date | 2023-05-04 |