| NPI | 1417438128 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: VA 0701007641) |
| Additional Taxonomies | 221700000X Art Therapist (Licence: NC 16-278) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VA 0718000311) | |
| Enumeration Date | 2018-08-22 |
| Last Update Date | 2018-08-22 |