| NPI | 1023147337 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: LA 1065) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL 798) |
| 101YP2500X Counselor, Professional (Licence: FL 78) | |
| Enumeration Date | 2007-03-04 |
| Last Update Date | 2013-06-17 |