| NPI | 1790791424 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VA 0710000451) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: VA 0701002808) |
| 101YM0800X Counselor, Mental Health (Licence: DC PRC1346) | |
| 101YM0800X Counselor, Mental Health (Licence: MD LC1145) | |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2025-09-11 |