| NPI | 1003049727 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: PA PC005001) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: PA PC005001 CAC, PCB) |
| 101YM0800X Counselor, Mental Health (Licence: PA PC005001 CCDP, PCB) | |
| Enumeration Date | 2009-08-27 |
| Last Update Date | 2009-12-11 |