| NPI | 1104020718 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NE 376) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NE 1671) |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2007-07-08 |