| NPI | 1083907281 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: VT 000538) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: VT 068.0122237) |
| Enumeration Date | 2011-05-20 |
| Last Update Date | 2018-10-29 |