| NPI | 1881854495 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC LPC 4645) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC LCAS 925, CSI 20020) | |
| Enumeration Date | 2008-06-17 |
| Last Update Date | 2015-09-21 |