| NPI | 1508881921 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC 4343) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC 4343) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 4343) | |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2012-04-05 |