| NPI | 1700555471 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) | 
| 101Y00000X Counselor | |
| Enumeration Date | 2021-09-07 | 
| Last Update Date | 2024-07-09 |