| NPI | 1093739955 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IN 010399 Certification) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IN 39000535A) |
| 1041C0700X Social Worker, Clinical (Licence: IN 34003706A) | |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2007-07-08 |