| NPI | 1912242173 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC 9440) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 2190A) |
| 101Y00000X Counselor (Licence: NC 265080) | |
| Enumeration Date | 2012-11-29 |
| Last Update Date | 2023-11-20 |