| NPI | 1114278264 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: VA 0701006634) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: NJ 37PC00446800) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: VA 0718000293) | |
| Enumeration Date | 2012-09-28 |
| Last Update Date | 2020-07-31 |