| NPI | 1013251909 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: VT 068.0068222) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VT 000601) |
| Enumeration Date | 2012-11-16 |
| Last Update Date | 2016-08-20 |