| NPI | 1093805194 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NC C002692) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: NC C002692) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NC 1369) | |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2013-06-10 |