| NPI | 1780219931 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AL c3426a) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AL ADC-941) |
| Enumeration Date | 2020-03-09 |
| Last Update Date | 2021-08-10 |