NPI | 1003942640 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH7959) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN1489872) |
101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL CAP2460) | |
163WP0808X Registered Nurse, Psych/Mental Health (Licence: FL RN 1489872) | |
Enumeration Date | 2007-02-26 |
Last Update Date | 2011-06-24 |