| NPI | 1154567071 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: LA 143) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: LA 122) |
| Enumeration Date | 2008-12-23 |
| Last Update Date | 2008-12-23 |