| NPI | 1457678922 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NC 1555) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: NC 1412) |
| Enumeration Date | 2010-04-23 |
| Last Update Date | 2012-01-31 |