NPI | 1225574635 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA A011120315) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF73056) |
Enumeration Date | 2017-01-09 |
Last Update Date | 2017-01-09 |