| NPI | 1801183850 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: NC 8965) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 2671) |
| 101YM0800X Counselor, Mental Health | |
| 101YM0800X Counselor, Mental Health (Licence: NC 8965) | |
| 101YP2500X Counselor, Professional (Licence: NC 8965) | |
| 171000000X Military Health Care Provider | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2011-06-28 |
| Last Update Date | 2024-04-23 |