| 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 |