| NPI | 1235503418 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: GA LPC009820) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: GA 58595) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: GA 780) | |
| Enumeration Date | 2015-11-25 |
| Last Update Date | 2018-12-08 |