| NPI | 1073707410 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0701001710) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VA 22757) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VA 0710000409) | |
| 101YP2500X Counselor, Professional (Licence: VA 22757) | |
| 106H00000X Marriage & Family Therapist (Licence: VA 0717000709) | |
| Enumeration Date | 2007-08-29 |
| Last Update Date | 2007-08-29 |