| NPI | 1306193065 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: LA 3745) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: LA 1255) |
| 101YP2500X Counselor, Professional (Licence: LA 298252) | |
| Enumeration Date | 2012-08-12 |
| Last Update Date | 2012-08-12 |