| NPI | 1023557733 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: PR 73881) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: PR 13685) |
| Enumeration Date | 2017-02-14 |
| Last Update Date | 2017-06-21 |