| NPI | 1205363009 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO 5628) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CO 5628) |
| 146M00000X Emergency Medical Technician, Intermediate (Licence: CO 061401) | |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2017-05-11 |