| NPI | 1053533182 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: RI ISW02553) | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: RI CDP00458) | 
| Enumeration Date | 2007-05-02 | 
| Last Update Date | 2015-10-18 |