| NPI | 1700125465 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: 9937) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 3197) |
| 101YP2500X Counselor, Professional (Licence: NC 9937) | |
| Enumeration Date | 2013-01-31 |
| Last Update Date | 2018-01-16 |