| NPI | 1912542093 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OR 24-QMHAR-5341) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR T-24-3619) |
| Enumeration Date | 2019-11-12 |
| Last Update Date | 2024-09-16 |