| NPI | 1700122710 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC 12137) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: 2487-A) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 2487-A) | |
| Enumeration Date | 2012-12-19 |
| Last Update Date | 2023-05-24 |