NPI | 1497816615 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101Y00000X Counselor (Licence: MA 06-101) |
Additional Taxonomies | 101Y00000X Counselor (Licence: MA 6130) |
101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MA 2210) | |
Enumeration Date | 2006-12-12 |
Last Update Date | 2010-11-17 |