NPI | 1457582405 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MO 2012012906) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 178.005312) |
101YP2500X Counselor, Professional (Licence: IL 180.007401) | |
Enumeration Date | 2009-08-06 |
Last Update Date | 2022-08-09 |