| NPI | 1932247632 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: ID 5497) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: ID 4754) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ID 1141008) | |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2024-01-08 |