| NPI | 1710566153 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NC A15582) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NC LCAS-25922) |
| 101YP2500X Counselor Professional (Licence: NC A15582) | |
| 101Y00000X Counselor (Licence: NC 1138411) | |
| Enumeration Date | 2021-04-05 |
| Last Update Date | 2022-03-03 |