| NPI | 1215089172 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: FL MH7283) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: FL CAP 2646) |
| 164X00000X Licensed Vocational Nurse (Licence: FL PN1247231) | |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2010-02-10 |