| NPI | 1063566081 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180005653) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 180005653) |
| 101YM0800X Counselor, Mental Health (Licence: IL 180-005653) | |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2012-07-16 |