| NPI | 1467722678 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NE 4421) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NE 9511) |
| 2084A0401X Psychiatry & Neurology Addiction Medicine (Licence: NE 9511) | |
| Enumeration Date | 2012-01-04 |
| Last Update Date | 2015-07-23 |