| NPI | 1528331162 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MT LCPC#8333) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MT #1304) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MT LAC#1304) | |
| Enumeration Date | 2012-02-13 |
| Last Update Date | 2015-02-13 |