| NPI | 1326032467 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: AZ LISAC0124) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: AZ LPC0034) |
| Enumeration Date | 2005-09-05 |
| Last Update Date | 2007-07-08 |