NPI | 1154390979 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | |
Primary Taxonomy | 101Y00000X Counselor (Licence: VA 0701002962) |
Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: VA 07018000109) |
Enumeration Date | 2006-03-15 |
Last Update Date | 2007-07-08 |