| NPI | 1053639583 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 1538-061511P) |
| Additional Taxonomies | 101YS0200X Counselor, School (Licence: CA 070104802) |
| Enumeration Date | 2010-05-07 |
| Last Update Date | 2010-05-07 |