| NPI | 1184033276 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) | 
| Enumeration Date | 2014-08-04 | 
| Last Update Date | 2019-05-08 |