| NPI | 1225259054 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO 5984) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CO 2848) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2007-07-08 |