| NPI | 1508292459 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NJ 37LC00182700) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NJ 44SW00424200) |
| Enumeration Date | 2013-09-24 |
| Last Update Date | 2013-09-24 |