| NPI | 1295964245 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MO 2009009104) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MO 500676) |
| Enumeration Date | 2009-07-13 |
| Last Update Date | 2010-12-22 |