| NPI | 1972836211 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NM 006248) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NM 0064411) |
| 101YM0800X Counselor, Mental Health (Licence: NM 0065682) | |
| Enumeration Date | 2009-09-17 |
| Last Update Date | 2009-09-17 |