| NPI | 1447403910 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NC 1231) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MI 6301006758) |
| Enumeration Date | 2008-10-28 |
| Last Update Date | 2010-05-14 |