| NPI | 1922173947 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: OR T0671) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OR 08-06-28) | |
| Enumeration Date | 2006-11-22 |
| Last Update Date | 2021-12-17 |