| NPI | 1548660277 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC LCAS-20895) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC A11298) |
| Enumeration Date | 2014-08-29 |
| Last Update Date | 2015-05-22 |