| NPI | 1033366687 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ 10274) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: SC 40152) |
| 101YM0800X Counselor, Mental Health (Licence: SC 40152) | |
| Enumeration Date | 2008-08-26 |
| Last Update Date | 2008-08-26 |