NPI | 1386974020 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MT 1458lcpc) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MT 1267lac) |
Enumeration Date | 2009-12-31 |
Last Update Date | 2010-06-16 |