| NPI | 1346584463 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 15604-131) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WI 1608-226) |
| Enumeration Date | 2012-11-15 |
| Last Update Date | 2013-01-09 |