| NPI | 1003163080 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: AR A1209075) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: AR 0339L) |
| Enumeration Date | 2012-08-09 |
| Last Update Date | 2015-07-23 |