| NPI | 1730212168 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 679) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NE 1584) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO 193) | |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2010-02-25 |