| NPI | 1104113943 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TN 2710) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TN 1512) | |
| Enumeration Date | 2011-06-30 |
| Last Update Date | 2024-05-06 |