| NPI | 1972884252 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH11413) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IN 39002283A) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL CAP 5818) | |
| Enumeration Date | 2011-08-31 |
| Last Update Date | 2015-10-23 |