| NPI | 1447417266 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WI 5160-125) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 16327130) |
| Enumeration Date | 2008-05-20 |
| Last Update Date | 2013-12-20 |