| NPI | 1083765119 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2010-06-25 |