| NPI | 1780455311 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: OR 22-QMHPC-001170) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OR 19-05-04) |
| Enumeration Date | 2024-01-11 |
| Last Update Date | 2024-01-11 |