| NPI | 1790026243 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: SD LPC-MH2235) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: SD 11091485) |
| Enumeration Date | 2013-03-08 |
| Last Update Date | 2020-11-05 |