NPI | 1407060130 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IA 001102) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IA 07038) |
Enumeration Date | 2007-05-10 |
Last Update Date | 2014-07-08 |