| NPI | 1801188495 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OR C6644) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 21-R-30) |
| 101YM0800X Counselor, Mental Health (Licence: ID LPC-4326) | |
| Enumeration Date | 2011-05-14 |
| Last Update Date | 2022-04-01 |