| NPI | 1457894412 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: FL MH13016) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: FL MH13016) |
| 101YM0800X Counselor Mental Health (Licence: FL MH13016) | |
| Enumeration Date | 2016-11-23 |
| Last Update Date | 2016-11-23 |