NPI | 1528431533 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO LPC 0012541) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO ACB 0007938) |
Enumeration Date | 2015-11-12 |
Last Update Date | 2015-11-12 |