| NPI | 1043550965 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MO 2010041725) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MO 2010041725) |
| Enumeration Date | 2013-03-01 |
| Last Update Date | 2013-03-01 |