| NPI | 1396118857 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO ACD.0000294) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VA MAC 507660) |
| 101YP2500X Counselor, Professional (Licence: CO LPC.0011167) | |
| Enumeration Date | 2015-11-05 |
| Last Update Date | 2016-01-21 |