| NPI | 1184134900 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: LA LAC1260) |
| Additional Taxonomies | 405300000X Prevention Professional (Licence: LA LPP1009) |
| Enumeration Date | 2017-10-06 |
| Last Update Date | 2017-10-06 |