| NPI | 1922765320 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 13251) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: P-2105) |
| Enumeration Date | 2021-11-19 |
| Last Update Date | 2024-09-27 |