| NPI | 1235689662 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 25812) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IL 31898) |
| Enumeration Date | 2016-10-10 |
| Last Update Date | 2016-10-10 |