| NPI | 1780045237 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MA 18677) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MA LMHC10001663) |
| Enumeration Date | 2016-03-11 |
| Last Update Date | 2024-02-05 |