| NPI | 1326237876 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MD LCA168) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MD LC5980) |
| 101YP1600X Counselor Pastoral (Licence: MD LC5980) | |
| Enumeration Date | 2007-10-22 |
| Last Update Date | 2015-08-24 |