| NPI | 1013331099 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MA 872) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MA 788) |
| Enumeration Date | 2014-02-11 |
| Last Update Date | 2016-08-29 |