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 |