| NPI | 1437792744 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NJ 37LC00259000) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NJ 37AC00369000) |
| Enumeration Date | 2019-10-21 |
| Last Update Date | 2019-10-21 |