| NPI | 1942666318 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: KS 2755) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KS 703) | |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2016-01-14 |
| Last Update Date | 2019-10-16 |