| NPI | 1760732747 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NM T-0153751) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NM 0151621) |
| Enumeration Date | 2012-09-17 |
| Last Update Date | 2012-10-22 |