| NPI | 1376758375 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NM 0124961) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NM 0126581) |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2010-01-08 |