| NPI | 1194040444 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: ID LCPC-4477) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ID LCPC-4477) |
| 101YP2500X Counselor, Professional (Licence: ID LCPC-4477) | |
| Enumeration Date | 2010-03-30 |
| Last Update Date | 2010-06-01 |