| NPI | 1811249691 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: MI 6401016578) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC A9927) |
| 101YP2500X Counselor, Professional (Licence: NC A9927) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IN 87001563A) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 3072-A) | |
| Enumeration Date | 2012-10-04 |
| Last Update Date | 2020-06-15 |