| NPI | 1780550350 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: VA 0732009192) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: VA 0732009192) |
| 101YM0800X Counselor Mental Health (Licence: VA 0732009192) | |
| 101YP2500X Counselor Professional (Licence: VA 0732009192) | |
| 251B00000X Case Management (Licence: VA 0732009192) | |
| 251S00000X Community/Behavioral Health (Licence: VA 0732009192) | |
| Enumeration Date | 2025-10-13 |
| Last Update Date | 2025-10-13 |