| NPI | 1417966961 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CT 001290) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CT 000038) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2018-03-26 |