| NPI | 1568530996 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: NC 3518) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NC 3518) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NC 1267) | |
| Enumeration Date | 2006-12-02 |
| Last Update Date | 2017-05-02 |