| NPI | 1356480859 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VA 0710101378) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: VA 0701003197) |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2007-07-08 |