| NPI | 1760894612 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: ID LPC-5055) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: ID 5806) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 101YM0800X Counselor, Mental Health | |
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2014-05-27 |
| Last Update Date | 2021-07-13 |