| NPI | 1215367776 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NJ 37AC00126500) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NJ 37AC00126500) |
| Enumeration Date | 2013-11-20 |
| Last Update Date | 2014-06-23 |