NPI | 1154466985 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC 3529 lpc) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 3392) |
Enumeration Date | 2007-02-20 |
Last Update Date | 2021-09-03 |