| NPI | 1053508705 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MD LC2572) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MD LC2572) |
| 101YM0800X Counselor, Mental Health (Licence: MD LC2572) | |
| Enumeration Date | 2007-09-26 |
| Last Update Date | 2014-08-07 |