| NPI | 1700040524 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NE 2531) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NE 517) |
| 101YP2500X Counselor Professional (Licence: NE 1376) | |
| Enumeration Date | 2008-07-10 |
| Last Update Date | 2008-07-10 |