| NPI | 1982342549 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0701011386)  | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: VA 0701011386)  | 
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VA 0701011386)  | |
| Enumeration Date | 2022-05-24 | 
| Last Update Date | 2022-05-24 |