| NPI | 1093836553 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: UT 314648-6006) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: UT 314648-3501) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2007-07-08 |