| NPI | 1720415839 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MN 3442) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 15-04-02) |
| 101YP2500X Counselor, Professional (Licence: OR C3755) | |
| Enumeration Date | 2013-10-03 |
| Last Update Date | 2024-07-25 |