| NPI | 1528008299 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: ND 1778) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: FL MH6159) |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2015-07-13 |