| NPI | 1003350372 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: GA 970) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: GA 804385) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: DC 21046) | |
| Enumeration Date | 2016-12-06 |
| Last Update Date | 2016-12-06 |