| NPI | 1336698042 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC LCAS-22910) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2016-09-23 |
| Last Update Date | 2018-10-04 |