| NPI | 1558410829 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 3416) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 7375) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NE 843) | |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2011-08-17 |