| NPI | 1992028914 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC 11567) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 680) |
| 101YP2500X Counselor, Professional (Licence: NC 11567) | |
| Enumeration Date | 2010-03-04 |
| Last Update Date | 2020-01-30 |