| NPI | 1003126970 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401012200) | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI 104717) | 
| 104100000X Social Worker (Licence: MI 6802063821) | |
| Enumeration Date | 2010-10-13 | 
| Last Update Date | 2010-10-13 |