NPI | 1386086718 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0701007209) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VA 0711000341) |
Enumeration Date | 2013-07-26 |
Last Update Date | 2018-07-24 |