| NPI | 1386693091 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VT 000059) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NH 0600) |
| 101YM0800X Counselor, Mental Health (Licence: VT 0680000181) | |
| 101YM0800X Counselor, Mental Health (Licence: NH 374) | |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2015-10-13 |