| NPI | 1831750025 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 180.008574) |
| 101YP2500X Counselor, Professional (Licence: CO LPC.0014683) | |
| 225C00000X Rehabilitation Counselor | |
| Enumeration Date | 2019-06-27 |
| Last Update Date | 2021-10-06 |