| NPI | 1538293543 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 11258) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IL 149-001266) |
| 106H00000X Marriage & Family Therapist (Licence: IL 166-000335) | |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2007-07-08 |