| NPI | 1376989020 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: PR 0323) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: PR 19604) |
| Enumeration Date | 2013-05-21 |
| Last Update Date | 2013-05-21 |