| NPI | 1912302696 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC A10750) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC LCAS-20098) |
| 101YP2500X Counselor, Professional (Licence: NC A10750) | |
| Enumeration Date | 2014-10-24 |
| Last Update Date | 2014-10-24 |