| NPI | 1164857272 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VA 0710101862) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: VA 0701005458) |
| Enumeration Date | 2013-09-09 |
| Last Update Date | 2013-09-09 |