| NPI | 1477893154 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IA 00677) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IA 01054) |
| 101YP2500X Counselor, Professional (Licence: NE 1186) | |
| Enumeration Date | 2013-02-18 |
| Last Update Date | 2013-05-29 |