NPI | 1164892667 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AL Lpc05240) |
Additional Taxonomies | 101YP2500X Counselor, Professional |
101YP2500X Counselor, Professional (Licence: AL Lpc05240) | |
Enumeration Date | 2015-09-28 |
Last Update Date | 2024-10-22 |