| NPI | 1104903236 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: ID LCPC 2838) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ID 1063004) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2023-01-25 |