| NPI | 1720636095 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 103TC1900X Psychologist, Counseling | |
| Enumeration Date | 2019-08-29 |
| Last Update Date | 2019-08-29 |