NPI | 1194130096 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: PA CD-0000035) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: DE 750) |
Enumeration Date | 2014-06-30 |
Last Update Date | 2014-06-30 |