| NPI | 1821468794 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: IL 180016781) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: 180016781) |
| 101YM0800X Counselor, Mental Health | |
| 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children | |
| Enumeration Date | 2015-10-04 |
| Last Update Date | 2026-07-29 |