| NPI | 1104042407 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OK 214365L) |
| 101YP2500X Counselor, Professional (Licence: OK 4722) | |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2013-05-14 |