| NPI | 1770029555 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NC A12599) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: NC A12599) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NC 23511) | |
| Enumeration Date | 2017-01-17 |
| Last Update Date | 2020-11-04 |