| NPI | 1215082144 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CT 000236) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CT 000605) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2007-07-08 |