| NPI | 1790400463 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WI 5216-226) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 5216-226) |
| 101YP2500X Counselor, Professional (Licence: WI 5216-226) | |
| 106H00000X Marriage & Family Therapist (Licence: WI 5216-226) | |
| Enumeration Date | 2022-10-05 |
| Last Update Date | 2022-10-05 |