| NPI | 1730838210 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC A17700) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC LCAS-27987) |
| 101YP2500X Counselor, Professional (Licence: NC A17700) | |
| Enumeration Date | 2022-03-22 |
| Last Update Date | 2022-06-11 |