| NPI | 1184690679 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 1453) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WI 3118-125) |
| Enumeration Date | 2006-02-24 |
| Last Update Date | 2012-07-02 |