NPI | 1811387780 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH13036) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL ADC-010302-2015) |
101YP2500X Counselor, Professional (Licence: GA LPC009537) | |
Enumeration Date | 2015-01-30 |
Last Update Date | 2019-07-18 |