NPI | 1942776679 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: VA 0701002244) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VA 0718000095) |
106H00000X Marriage & Family Therapist (Licence: VA 00717000541) | |
Enumeration Date | 2018-10-20 |
Last Update Date | 2021-08-18 |