| NPI | 1376889923 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC LPCA- A9865) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC LCASA 3056-A) | |
| Enumeration Date | 2012-12-28 |
| Last Update Date | 2012-12-28 |