| NPI | 1790559987 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YP2500X Counselor, Professional | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL MCAP100843) | 
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2023-11-08 | 
| Last Update Date | 2023-11-08 |