| NPI | 1780053629 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MA LMHC5000780) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 222Q00000X Developmental Therapist | |
| Enumeration Date | 2015-09-22 |
| Last Update Date | 2023-12-02 |