| NPI | 1770299877 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: VA 0704011835) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: VA 0710103366) |
| Enumeration Date | 2023-01-23 |
| Last Update Date | 2023-01-23 |