| NPI | 1174792303 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MI 6401009368) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI C00579) |
| 101YP2500X Counselor, Professional (Licence: MI L1226537) | |
| Enumeration Date | 2008-02-21 |
| Last Update Date | 2023-12-28 |