| NPI | 1568581544 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WI 12147) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: WI 892) |
| 1041C0700X Social Worker Clinical (Licence: WI 1756) | |
| 106H00000X Marriage & Family Therapist (Licence: WI 388) | |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2007-07-08 |