| NPI | 1801168653 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 1303) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NE 1030) |
| 101YP2500X Counselor, Professional (Licence: NE 2188) | |
| Enumeration Date | 2012-02-08 |
| Last Update Date | 2019-02-26 |