| NPI | 1437415866 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: DC PRC16) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MD LCA359) |
| Enumeration Date | 2012-04-10 |
| Last Update Date | 2012-04-11 |