| NPI | 1902527385 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health (Licence: VA 0904009333) | |
| 101YP1600X Counselor, Pastoral | |
| Enumeration Date | 2022-09-06 |
| Last Update Date | 2022-09-06 |