| NPI | 1366952087 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VT 151.0126271) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: VT 089.0085301) |
| Enumeration Date | 2017-10-08 |
| Last Update Date | 2017-10-08 |