| NPI | 1770889339 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NC A8404) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NC 3277-A) |
| Enumeration Date | 2011-01-31 |
| Last Update Date | 2015-04-23 |