NPI | 1164792396 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101Y00000X Counselor (Licence: OR c2784) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 070603) |
Enumeration Date | 2012-01-04 |
Last Update Date | 2012-01-04 |