| NPI | 1912785213 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: LA 3149) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: LA 1027) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: LA 1013) | |
| Enumeration Date | 2023-09-18 |
| Last Update Date | 2023-09-18 |