| NPI | 1326030479 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: NE 7457) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NE P-468) |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2015-07-27 |