| NPI | 1558465047 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MT 789) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: MT 728) |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2007-07-08 |