| NPI | 1457457772 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MT BBHLCPC1492) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MT 1161) |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2023-02-06 |