| NPI | 1710644562 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: RI MHC01639) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AZ LPC-23684) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: RI CDP00762) | |
| Enumeration Date | 2021-11-29 |
| Last Update Date | 2026-02-02 |