| NPI | 1962645291 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AZ 11404) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ 11378) |
| 101YM0800X Counselor, Mental Health (Licence: NC 6938) | |
| Enumeration Date | 2009-04-16 |
| Last Update Date | 2009-04-16 |