| NPI | 1063881225 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0701006305) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VA 0710102862) |
| Enumeration Date | 2015-09-17 |
| Last Update Date | 2015-10-07 |