| NPI | 1356496061 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: NM 005527) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: F18506) |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2022-11-30 |