| NPI | 1992149942 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: SC 4509) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: SC 1210025) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: SC 604) | |
| Enumeration Date | 2013-04-22 |
| Last Update Date | 2021-04-23 |