| NPI | 1326378126 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: OR C2599) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OR C2599) |
| 101YP2500X Counselor, Professional (Licence: OR C2599) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 09-06-17) | |
| Enumeration Date | 2009-12-30 |
| Last Update Date | 2011-02-16 |