| NPI | 1518349232 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC LCAS-21327) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: NC 1857) |
| Enumeration Date | 2015-06-19 |
| Last Update Date | 2018-01-24 |