| NPI | 1518219351 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: ID LCPC4822) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: ID 4822) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: ID MAC23903) | |
| Enumeration Date | 2012-10-03 |
| Last Update Date | 2023-07-14 |