| NPI | 1912291121 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: VT 100.0057970) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NH 0987) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VT 151.0127914) | |
| 101YM0800X Counselor, Mental Health (Licence: NH 0987) | |
| Enumeration Date | 2011-06-06 |
| Last Update Date | 2022-05-26 |