| NPI | 1740733880 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 11554) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MA 18140) |
| 101YM0800X Counselor, Mental Health (Licence: NC 17541) | |
| Enumeration Date | 2016-07-25 |
| Last Update Date | 2024-01-16 |