| NPI | 1871147520 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AK 182614)  | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AK 4679)  | 
| 101YM0800X Counselor, Mental Health (Licence: WA MX61300797)  | |
| Enumeration Date | 2019-07-31 | 
| Last Update Date | 2024-06-01 |