| NPI | 1336139302 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: TX 3377) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: NC 2874) |
| 106H00000X Marriage & Family Therapist (Licence: NC 003662-042571) | |
| Enumeration Date | 2005-10-21 |
| Last Update Date | 2007-07-08 |