| NPI | 1962633941 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NH 1975) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MA 504759) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MA 10141) | |
| Enumeration Date | 2009-08-07 |
| Last Update Date | 2016-11-29 |