| NPI | 1376064964 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 225800000X Recreation Therapist | |
| Enumeration Date | 2017-07-05 |
| Last Update Date | 2017-07-05 |