| NPI | 1477795243 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MA 1034AD) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MA 5454) |
| Enumeration Date | 2009-03-25 |
| Last Update Date | 2012-03-28 |