| NPI | 1114006640 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC 4786) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 1080) |
| 101YM0800X Counselor, Mental Health (Licence: NC 4786) | |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2016-05-25 |