| NPI | 1114066552 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WI 2555-125) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 2555125) |
| 101YM0800X Counselor, Mental Health (Licence: WI 2555-125) | |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2007-07-09 |