| NPI | 1992353494 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MD LGP9340) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MD AC1592) |
| 101YP2500X Counselor, Professional (Licence: MD LGP9340) | |
| Enumeration Date | 2019-08-28 |
| Last Update Date | 2019-08-28 |