| NPI | 1235401373 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO 0000387) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CO 3570) |
| Enumeration Date | 2012-02-06 |
| Last Update Date | 2015-10-03 |