| NPI | 1750769592 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MT SWP-LCPC-LIC-11066) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MT LAC-LAC-LIC-4139) |
| Enumeration Date | 2015-05-13 |
| Last Update Date | 2021-04-07 |