| NPI | 1477751170 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: SC 2895 and 3865) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: SC 2895, 3865) |
| Enumeration Date | 2007-07-05 |
| Last Update Date | 2018-07-12 |