| NPI | 1114233798 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AL 2813) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AL 141) |
| 101YP2500X Counselor, Professional (Licence: AL 237501) | |
| Enumeration Date | 2010-08-20 |
| Last Update Date | 2016-05-31 |