| NPI | 1952761835 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: IL 180.011819) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 101Y00000X Counselor | |
| 101YA0400X Counselor Addiction (Substance Use Disorder) | |
| Enumeration Date | 2016-03-04 |
| Last Update Date | 2022-07-21 |