| NPI | 1013159375 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: WV 2008-2524) |
| Enumeration Date | 2009-04-01 |
| Last Update Date | 2025-01-17 |