| NPI | 1386690410 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: IL CRC C043122) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ LISAC 10322) |
| 101YM0800X Counselor, Mental Health (Licence: AZ LPC 11589) | |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2007-07-08 |