| NPI | 1982114328 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WI 7615-125) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 16445-131) | |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2017-10-11 |
| Last Update Date | 2023-05-01 |