| NPI | 1972084077 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: LA 8970) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 37638) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: LA 5010) | |
| Enumeration Date | 2018-08-27 |
| Last Update Date | 2024-04-27 |