| NPI | 1124122247 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MD LC0271) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MD ACO998) |
| Enumeration Date | 2006-09-11 |
| Last Update Date | 2016-11-30 |