| NPI | 1083919542 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NC 1589) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NC 00111030) |
| 101YM0800X Counselor Mental Health (Licence: NC A8066) | |
| Enumeration Date | 2011-01-14 |
| Last Update Date | 2011-06-22 |