| NPI | 1760657308 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: SD LPCMH2061) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: QMHP) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: SD LAC9707970) | |
| Enumeration Date | 2008-04-24 |
| Last Update Date | 2015-08-31 |