| NPI | 1477755999 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: LA 2609) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: LA 703) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: LA 1004) | |
| Enumeration Date | 2007-06-05 |
| Last Update Date | 2017-03-09 |