| NPI | 1760701627 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO 3791) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO 3327) |
| 101YM0800X Counselor, Mental Health (Licence: CO 88758) | |
| Enumeration Date | 2010-05-18 |
| Last Update Date | 2022-06-16 |