| NPI | 1124492525 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL MH13193) |
| Additional Taxonomies | 251S00000X (Licence: FL MH13193) |
| Enumeration Date | 2015-11-23 |
| Last Update Date | 2015-11-23 |