| NPI | 1073668752 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NE 1423) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NE 656) |
| 101YM0800X Counselor, Mental Health (Licence: NE 630) | |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2017-04-07 |