| NPI | 1255729570 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 2503) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NC 2503) |
| 101YP2500X Counselor, Professional (Licence: NC 2503) | |
| 103K00000X Behavior Analyst (Licence: NC 2503) | |
| Enumeration Date | 2015-01-08 |
| Last Update Date | 2015-01-08 |