NPI | 1083835250 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO LPC 2060) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO 0427) |
Enumeration Date | 2007-05-02 |
Last Update Date | 2021-12-14 |