| NPI | 1053674960 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101YP1600X Counselor Pastoral |
| Enumeration Date | 2012-06-18 |
| Last Update Date | 2014-06-05 |