| NPI | 1184894834 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NC A10403) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NC 3555-A) |
| Enumeration Date | 2008-03-10 |
| Last Update Date | 2014-01-15 |