| NPI | 1124360516 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: DC PRC14152) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: DC CACII1131) |
| 101YP2500X Counselor, Professional (Licence: MD LC5764) | |
| Enumeration Date | 2013-03-23 |
| Last Update Date | 2014-07-22 |