| NPI | 1538557772 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: NE 6895) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 10108) |
| Enumeration Date | 2014-12-22 |
| Last Update Date | 2014-12-22 |