| NPI | 1114945607 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VA 0718000039) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: VA 0701000524) |
| 101YP2500X Counselor, Professional (Licence: DC PRC882) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2007-07-08 |