NPI | 1477738086 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180.007132) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 23210) |
106H00000X Marriage & Family Therapist (Licence: IL 166.000847) | |
Enumeration Date | 2008-01-02 |
Last Update Date | 2023-01-24 |