| NPI | 1366635336 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VA 0701004966) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2007-08-23 |
| Last Update Date | 2010-12-13 |