| NPI | 1235388497 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ LISAC10393) |
| Additional Taxonomies | 104100000X Social Worker (Licence: AZ LMSW12240) |
| Enumeration Date | 2008-09-12 |
| Last Update Date | 2008-09-12 |