NPI | 1346631967 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC002094) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: GA CE# 1687) |
Enumeration Date | 2015-02-18 |
Last Update Date | 2015-02-18 |