| NPI | 1013499714 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL CAC100165) |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility (Licence: FL CAC100165) |
| 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children (Licence: FL CAC100165) | |
| 374K00000X (Licence: FL CAC100165) | |
| Enumeration Date | 2018-08-30 |
| Last Update Date | 2018-08-30 |