| NPI | 1972260180 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IA 111880) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: SD 03121173) |
| 101YM0800X Counselor, Mental Health (Licence: SD LPCMH2270) | |
| Enumeration Date | 2021-11-22 |
| Last Update Date | 2022-01-21 |