| NPI | 1497190466 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: FL 193) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: FL 50291) |
| Enumeration Date | 2013-05-06 |
| Last Update Date | 2013-05-06 |