| NPI | 1194763136 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OK 420) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: OK 1325) |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2007-07-08 |