| NPI | 1972741270 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CO 2752) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO 7401) |
| Enumeration Date | 2009-01-26 |
| Last Update Date | 2019-01-22 |