| NPI | 1033109350 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH6007) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL 984) |
| Enumeration Date | 2005-10-27 |
| Last Update Date | 2015-06-30 |