| NPI | 1538105937 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 109) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NC 1849) |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2007-07-08 |