| NPI | 1467660381 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: FL 1807) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: FL MT1649) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2015-07-01 |