| NPI | 1831542224 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OR C4246) | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 14-09-10) | 
| Enumeration Date | 2016-07-20 | 
| Last Update Date | 2022-08-23 |