| NPI | 1083157416 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: OR C4979) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OR 03-03-60) |
| Enumeration Date | 2016-12-03 |
| Last Update Date | 2018-09-06 |