| NPI | 1194821579 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VT 000029) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: VT 047-0000410) |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2007-07-08 |