| NPI | 1114227493 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: SC 5263) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 1694) |
| 101YP2500X Counselor, Professional (Licence: NC 8523) | |
| Enumeration Date | 2010-11-02 |
| Last Update Date | 2013-03-18 |