| NPI | 1205909264 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IL 180004554) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: IL 180004554) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 180004554) | |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2011-10-26 |