| NPI | 1366738783 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AZ 16412) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 15690-131) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 15665-132) | |
| 101YP2500X Counselor, Professional (Licence: WI 5578-125) | |
| Enumeration Date | 2011-06-23 |
| Last Update Date | 2017-11-15 |