| NPI | 1871154435 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WI 18126-130) |
| 101YP2500X Counselor Professional (Licence: WI 4301-226) | |
| Enumeration Date | 2019-06-25 |
| Last Update Date | 2022-12-05 |