| NPI | 1740796655 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: LA 7285) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CO 0014193) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2017-12-15 |
| Last Update Date | 2020-09-21 |