| NPI | 1295743250 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: VA 0710000073) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: VA 0701001069) |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2007-07-08 |