| NPI | 1508189663 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 225400000X Rehabilitation Practitioner | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) | 
| Enumeration Date | 2010-03-03 | 
| Last Update Date | 2013-09-18 |