| NPI | 1134686686 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VA 0710102445) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: VA 0732001983) |
| Enumeration Date | 2019-02-20 |
| Last Update Date | 2019-02-20 |