| NPI | 1902218787 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OR C4259) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 14-03-20) |
| 101YM0800X Counselor, Mental Health (Licence: OR LPC C4259) | |
| Enumeration Date | 2014-05-28 |
| Last Update Date | 2016-12-28 |