| NPI | 1427411974 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: LA 1426) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: LA 008026059) |
| Enumeration Date | 2016-04-01 |
| Last Update Date | 2016-11-01 |