| NPI | 1720625049 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health (Licence: WI 7668-125) | |
| 101YP2500X Counselor, Professional (Licence: WI 7668-125) | |
| Enumeration Date | 2019-12-05 |
| Last Update Date | 2024-10-16 |