| NPI | 1295187375 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251S00000X (Licence: CO 1537-03) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO 1537-03) |
| Enumeration Date | 2016-07-12 |
| Last Update Date | 2017-09-15 |