| NPI | 1255676995 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NC 2738-A) |
| Additional Taxonomies | 302R00000X Health Maintenance Organization (Licence: NC 2738-A) |
| Enumeration Date | 2012-12-06 |
| Last Update Date | 2012-12-06 |