| NPI | 1013225572 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: FL SW6783) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: FL 2575) |
| Enumeration Date | 2010-09-18 |
| Last Update Date | 2010-09-18 |