| NPI | 1720552706 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NC A14540) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NC 24534) |
| 101YP2500X Counselor Professional | |
| Enumeration Date | 2019-01-14 |
| Last Update Date | 2019-02-05 |