| NPI | 1417202045 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL 5280) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL 8995) |
| Enumeration Date | 2012-07-19 |
| Last Update Date | 2013-03-01 |