| NPI | 1245668193 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: SC 8276) |
| Enumeration Date | 2013-10-30 |
| Last Update Date | 2016-11-03 |