NPI | 1700422284 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IL 178.015342) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 36078) |
Enumeration Date | 2019-11-20 |
Last Update Date | 2019-12-11 |