NPI | 1750653580 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WI 1238-266) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 16489-130) |
101YM0800X Counselor, Mental Health | |
261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
Enumeration Date | 2012-02-09 |
Last Update Date | 2024-02-21 |