| NPI | 1093203093 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: IL 180.004044) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: IL 180.004044) |
| Enumeration Date | 2018-04-25 |
| Last Update Date | 2018-09-24 |