| NPI | 1528329315 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WI 15451-132) |
| Additional Taxonomies | 104100000X Social Worker (Licence: WI 8511-120) |
| Enumeration Date | 2012-06-07 |
| Last Update Date | 2012-06-07 |