| NPI | 1528194164 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: OK LPC 1522) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: OK CCPS 95) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OK LADC 422) | |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2007-07-08 |