| NPI | 1336344753 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MA 765) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MA 6012) |
| 106H00000X Marriage & Family Therapist (Licence: MA 1234) | |
| Enumeration Date | 2007-06-16 |
| Last Update Date | 2007-07-08 |