| NPI | 1962889436 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WI 5464-125) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 15875-132) |
| 101YM0800X Counselor, Mental Health (Licence: WI 5464125) | |
| Enumeration Date | 2015-05-04 |
| Last Update Date | 2024-08-08 |