| NPI | 1811594583 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NE 1552) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 12363) | 
| Enumeration Date | 2020-10-06 | 
| Last Update Date | 2023-12-20 |