| NPI | 1235120270 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: PA 3985) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: PA PC0022205) |
| Enumeration Date | 2005-10-31 |
| Last Update Date | 2007-07-09 |