| NPI | 1538353917 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MA 2089) |
| 101YP2500X Counselor, Professional (Licence: 25126) | |
| Enumeration Date | 2007-08-29 |
| Last Update Date | 2021-03-11 |