| NPI | 1245395367 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: SC 0610276) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: SC 2273) |
| 106H00000X Marriage & Family Therapist (Licence: SC 3941) | |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2007-07-08 |