| NPI | 1528559994 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IA 12048) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IA 001635) |
| Enumeration Date | 2018-05-22 |
| Last Update Date | 2018-05-22 |