| NPI | 1407978729 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MA 1434) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MA 3015036) |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2007-07-08 |