| NPI | 1942833520 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: VA 0710102917) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: VA 0701011581) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: VA 0718000545) | |
| 101YM0800X Counselor Mental Health (Licence: VA 0704012482) | |
| 101YP2500X Counselor Professional (Licence: VA 0701011581) | |
| Enumeration Date | 2020-02-21 |
| Last Update Date | 2023-10-10 |