| NPI | 1174687362 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NH 314 expiration 6 07) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NH 0455) |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2012-02-15 |