| NPI | 1720643265 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: SC LPC9062PC) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: GA 1020) |
| 101YP2500X Counselor Professional (Licence: GA LPC013050) | |
| Enumeration Date | 2019-05-09 |
| Last Update Date | 2024-04-17 |