NPI | 1114119179 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: SD LPC-MH2172) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: SD 06111289) |
Enumeration Date | 2007-08-14 |
Last Update Date | 2010-03-05 |