| NPI | 1386923589 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: NC 8768) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 101YM0800X Counselor Mental Health (Licence: NC 8768) | |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NC 1881) | |
| Enumeration Date | 2011-08-05 |
| Last Update Date | 2014-02-03 |