| NPI | 1316967334 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: NC 4804) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: VA 0718000386) |
| 101YP2500X Counselor Professional (Licence: VA 0701005902) | |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2021-10-13 |