| NPI | 1811558885 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC 11404) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NC 347869) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 21331) | |
| Enumeration Date | 2019-06-21 |
| Last Update Date | 2020-08-11 |