| NPI | 1144222845 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC 6111762) |
| Enumeration Date | 2005-08-12 |
| Last Update Date | 2015-08-19 |