| NPI | 1972916260 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NC 11348) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NC LCAS-20677) |
| 101YP2500X Counselor Professional (Licence: NC 11348) | |
| Enumeration Date | 2014-06-04 |
| Last Update Date | 2023-05-12 |