| NPI | 1558642223 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NV 01204) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NV 00320-LC) |
| Enumeration Date | 2011-09-07 |
| Last Update Date | 2015-07-10 |