| NPI | 1104146380 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: IA 001526) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: IA 15118) |
| Enumeration Date | 2010-06-10 |
| Last Update Date | 2017-11-03 |