| NPI | 1164773032 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NCC982567) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL MH11184) | |
| Enumeration Date | 2012-10-02 |
| Last Update Date | 2019-12-17 |