| NPI | 1164820890 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: GA APC0003728) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: GA 2056) |
| Enumeration Date | 2014-12-11 |
| Last Update Date | 2014-12-11 |