| NPI | 1992129266 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NC 1828) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NC 12321) |
| 101YM0800X Counselor Mental Health (Licence: NC 12321) | |
| 101YP2500X Counselor Professional (Licence: NC 12321) | |
| 225C00000X Rehabilitation Counselor (Licence: IL 00102070) | |
| Enumeration Date | 2014-02-07 |
| Last Update Date | 2019-07-06 |