| NPI | 1124320643 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: PA PC005576) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: PA Certification 7054) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: PA CERTIFICATION#7054) | |
| Enumeration Date | 2010-12-04 |
| Last Update Date | 2012-06-04 |