| NPI | 1174812051 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: OR C2988) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 08-06-27) | |
| Enumeration Date | 2011-03-31 |
| Last Update Date | 2013-01-08 |