| NPI | 1215060694 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IN 34001189A) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: 35000576A) |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2007-07-08 |