NPI | 1265560312 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MO 2005030618) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MO 2983) |
Enumeration Date | 2007-03-01 |
Last Update Date | 2014-10-28 |