| NPI | 1124415989 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AK 3986) |
| Additional Taxonomies | 101Y00000X Counselor |
| 1041C0700X Social Worker, Clinical (Licence: AK 112367) | |
| Enumeration Date | 2015-04-20 |
| Last Update Date | 2017-05-03 |