| NPI | 1477892792 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 2427) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: PA 4255) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: PA 4255) | |
| Enumeration Date | 2013-02-06 |
| Last Update Date | 2013-02-06 |