| NPI | 1407013626 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC LPC 6965) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VA MAC 500-120) |
| Enumeration Date | 2008-05-16 |
| Last Update Date | 2008-05-16 |