| NPI | 1487756078 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MD LC2062) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MD LCA436) |
| 101YP2500X Counselor, Professional (Licence: WV 1775) | |
| Enumeration Date | 2006-09-02 |
| Last Update Date | 2021-09-27 |