| NPI | 1215098652 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NE 532) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ICADC23252) |
| 101YM0800X Counselor, Mental Health (Licence: NE 8619) | |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2013-05-22 |