NPI | 1245417047 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CT 000939) |
Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: NY 17215) |
Enumeration Date | 2008-01-24 |
Last Update Date | 2011-12-29 |