NPI | 1255678777 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101Y00000X Counselor (Licence: VT 068.0000694) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VT 000450) |
Enumeration Date | 2013-01-04 |
Last Update Date | 2013-01-04 |