| NPI | 1801243829 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 22314) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: NC 11046A) |
| 106H00000X Marriage & Family Therapist (Licence: NC 2030) | |
| Enumeration Date | 2016-05-19 |
| Last Update Date | 2020-10-14 |