| NPI | 1932511052 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MT 1372) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MT 1197) |
| 101YM0800X Counselor Mental Health (Licence: MT 42772) | |
| Enumeration Date | 2014-05-22 |
| Last Update Date | 2020-05-05 |