| NPI | 1790935039 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: SC 107092) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: SC 5630) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: SC 361) | |
| Enumeration Date | 2008-09-23 |
| Last Update Date | 2021-08-31 |