| NPI | 1326265612 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MA 6453) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MA 6453) |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2008-01-16 |