| NPI | 1194118828 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO 484) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CO 2372) |
| Enumeration Date | 2015-03-04 |
| Last Update Date | 2016-02-17 |