| NPI | 1811007271 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 2005) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NE 381) |
| 101YM0800X Counselor, Mental Health (Licence: NE 759) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2012-06-04 |