| NPI | 1992090294 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 1261) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NE P-1114) |
| 101YM0800X Counselor, Mental Health (Licence: NE 4255) | |
| Enumeration Date | 2011-06-14 |
| Last Update Date | 2015-07-14 |