| NPI | 1811664204 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: SD LPCMH30651) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: SD 9809027) |
| 101YM0800X Counselor Mental Health (Licence: SD LPC20656) | |
| 101YP2500X Counselor Professional (Licence: SD LPC20656) | |
| Enumeration Date | 2021-08-24 |
| Last Update Date | 2024-01-15 |