| NPI | 1700977790 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 781) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 2242) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NE P-1008) | |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2013-08-19 |