| NPI | 1891032074 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: CO LPC.0012691) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: ACD.0001327) | |
| Enumeration Date | 2013-01-08 |
| Last Update Date | 2021-05-05 |