| NPI | 1053636159 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VA 0710103447) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: VA 0812000685) |
| 103K00000X Behavior Analyst | |
| Enumeration Date | 2010-03-31 |
| Last Update Date | 2020-04-01 |