| NPI | 1427456581 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: 086267) |
| Additional Taxonomies | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: 16176) | |
| Enumeration Date | 2014-12-05 |
| Last Update Date | 2020-07-06 |