| NPI | 1366863623 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO 0000471) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CO 0012912) |
| 106H00000X Marriage & Family Therapist (Licence: CO 001294) | |
| Enumeration Date | 2014-01-03 |
| Last Update Date | 2018-09-18 |