| NPI | 1992747968 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: OK 10397) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: KS 1237) |
| 103TC0700X Psychologist Clinical (Licence: KS 728) | |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2021-12-29 |