| NPI | 1124044854 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VA 0718000061) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: VA 0701002404) |
| 106H00000X Marriage & Family Therapist (Licence: VA 0717000098) | |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2007-07-08 |