| NPI | 1760087837 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MD LC9296) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MD AC1649) |
| Enumeration Date | 2020-12-04 |
| Last Update Date | 2020-12-04 |