| NPI | 1275804254 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101Y00000X Counselor |
| 1041S0200X Social Worker School | |
| Enumeration Date | 2012-01-23 |
| Last Update Date | 2012-01-23 |