| NPI | 1821200775 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MO 2007035326) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MO 2007035326) |
| 101YM0800X Counselor Mental Health (Licence: MO 2007035326) | |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2008-01-07 |