| NPI | 1447503438 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI L1778721) | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI O-01758) | 
| Enumeration Date | 2012-10-16 | 
| Last Update Date | 2012-10-16 |