| NPI | 1184609828 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WV 1742) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: DE 197) |
| 101YP2500X Counselor, Professional (Licence: DE pc0000270) | |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2020-12-20 |