NPI | 1033263652 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101Y00000X Counselor (Licence: WY LPC-1129) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ND 1512) |
Enumeration Date | 2007-01-22 |
Last Update Date | 2011-08-25 |