NPI | 1710123617 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO LPC.0000574) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO ACD.0000188) |
101YP2500X Counselor, Professional (Licence: CO 574) | |
Enumeration Date | 2008-12-23 |
Last Update Date | 2022-07-06 |