| NPI | 1083082689 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC 12098) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 3567) |
| 101YP2500X Counselor, Professional (Licence: NC A12098) | |
| Enumeration Date | 2015-09-14 |
| Last Update Date | 2021-10-15 |