| NPI | 1558676023 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC005857) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: GA 218074) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: GA 4021) | |
| Enumeration Date | 2010-08-09 |
| Last Update Date | 2010-08-09 |