| NPI | 1972929735 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH13616) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NH 2473) |
| 101YM0800X Counselor, Mental Health (Licence: FL IMH11106) | |
| Enumeration Date | 2014-03-17 |
| Last Update Date | 2022-06-06 |