| NPI | 1245543453 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: NJ 44SW00330700) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NJ 37LC00032400) |
| Enumeration Date | 2010-07-16 |
| Last Update Date | 2010-07-16 |