| NPI | 1508010356 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: CA RS5064) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: CA RW2341) |
| Enumeration Date | 2008-11-06 |
| Last Update Date | 2011-06-03 |