| NPI | 1851789465 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MT SWP-LCPC-LIC-2435) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MT LAC-LAC-LIC-1406) |
| Enumeration Date | 2015-01-05 |
| Last Update Date | 2015-01-05 |