| NPI | 1770136616 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC 11830) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NC 11830) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 20587) | |
| 101YM0800X Counselor, Mental Health (Licence: NC 11830) | |
| Enumeration Date | 2019-07-19 |
| Last Update Date | 2022-09-13 |