| NPI | 1407290117 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: GA LPC006374) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: GA LPC006374) |
| 101YM0800X Counselor, Mental Health (Licence: GA LPC006374) | |
| Enumeration Date | 2013-04-24 |
| Last Update Date | 2016-06-22 |