| NPI | 1851539951 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: VA LPC # 0701004473) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VA LPC # 0701004473) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL LMHC8188) | |
| 101YM0800X Counselor, Mental Health (Licence: FL LMHC8188) | |
| 101YP2500X Counselor, Professional (Licence: VA LPC # 0701004473) | |
| Enumeration Date | 2009-01-27 |
| Last Update Date | 2009-01-27 |