| NPI | 1285644534 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VT 000312) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: VT 000312) |
| 101YM0800X Counselor, Mental Health (Licence: VT 000312) | |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2011-09-02 |