| NPI | 1962032904 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 5439) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NE 2567) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NE 1296) | |
| Enumeration Date | 2020-01-17 |
| Last Update Date | 2020-01-24 |