| NPI | 1033473038 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 1864) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NC 4496) |
| Enumeration Date | 2012-06-25 |
| Last Update Date | 2022-07-21 |