| NPI | 1306178918 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MO 2008010475) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MO 2008010475) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MO 5030) | |
| Enumeration Date | 2010-02-06 |
| Last Update Date | 2010-02-06 |