| NPI | 1235571787 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC 10305) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: VA 0701008817) |
| 101Y00000X Counselor (Licence: NC 10305) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 3250) | |
| Enumeration Date | 2013-07-25 |
| Last Update Date | 2020-07-27 |