| NPI | 1215238464 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MA 1030338) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MA 1030338) |
| 101YM0800X Counselor, Mental Health (Licence: MA 1030338) | |
| Enumeration Date | 2010-11-04 |
| Last Update Date | 2017-01-23 |