| NPI | 1417256298 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 178.006154) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 27167) |
| Enumeration Date | 2011-03-20 |
| Last Update Date | 2011-03-20 |