| NPI | 1982001376 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health | 
| 1041C0700X Social Worker, Clinical (Licence: OR L7340) | |
| Enumeration Date | 2014-12-01 | 
| Last Update Date | 2024-10-02 |