| NPI | 1952543225 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: SD LPC-MH2205) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: SD 08111373) |
| 101YP2500X Counselor Professional (Licence: SD LPC7067) | |
| Enumeration Date | 2009-04-01 |
| Last Update Date | 2024-04-19 |