| NPI | 1942345335 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180001462) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WI 3948125) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 394825) | |
| 101YM0800X Counselor, Mental Health (Licence: WI 3948125) | |
| 101YM0800X Counselor, Mental Health (Licence: IL 180001462) | |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2015-03-01 |