| NPI | 1104983048 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CO 5828) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: CO 992199) |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2007-07-08 |