| NPI | 1811291164 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OR C5074) |
| 101YP2500X Counselor Professional (Licence: OR C5074) | |
| Enumeration Date | 2010-12-30 |
| Last Update Date | 2023-10-10 |