| NPI | 1447595558 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: LA CIT 3212) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: LA CI 5266) |
| Enumeration Date | 2012-11-29 |
| Last Update Date | 2012-11-29 |