| NPI | 1326410705 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: ID LPC-6594) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: ID 1028900) |
| Enumeration Date | 2015-10-26 |
| Last Update Date | 2022-07-21 |