NPI | 1285914556 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AR P1206062) |
Additional Taxonomies | 101Y00000X Counselor |
101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AR 347L) | |
101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VA 508408) | |
Enumeration Date | 2011-08-18 |
Last Update Date | 2017-03-24 |