| NPI | 1902440134 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health (Licence: FL MCAP100733) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL CMHP100032) |
| 101YP2500X Counselor, Professional (Licence: FL MCAP100733) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL MCAP100733) | |
| Enumeration Date | 2019-10-31 |
| Last Update Date | 2020-02-07 |