NPI | 1104138239 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL CAP-4255) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: FL SW9306) |
Enumeration Date | 2010-07-06 |
Last Update Date | 2013-06-05 |