| NPI | 1558694414 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NE 1787) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NE 402) |
| 101YM0800X Counselor, Mental Health (Licence: NE 3564) | |
| Enumeration Date | 2009-09-10 |
| Last Update Date | 2015-04-15 |