| NPI | 1710997432 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WI 3760-125) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MI 6401014463) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 14626-132) | |
| 101YM0800X Counselor, Mental Health (Licence: UT 5576626-6004) | |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2016-10-06 |