| NPI | 1841398906 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0701006204) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NC 9378) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 1707) | |
| 101YP2500X Counselor, Professional (Licence: GA 008039) | |
| 101YP2500X Counselor, Professional (Licence: MD LCPC7200) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2017-01-11 |