| NPI | 1437523925 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI 2-00962) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MI 6401013580) |
| Enumeration Date | 2015-11-20 |
| Last Update Date | 2015-11-20 |