| NPI | 1134591670 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) | 
| Additional Taxonomies | 1041C0700X Social Worker, Clinical | 
| Enumeration Date | 2015-10-23 | 
| Last Update Date | 2015-10-23 |