| NPI | 1255675112 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WI 4958-125) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 15898-130) |
| 106H00000X Marriage & Family Therapist (Licence: WI 178-228) | |
| Enumeration Date | 2012-11-15 |
| Last Update Date | 2013-11-29 |