| NPI | 1568614972 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL SW4630) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: FL SW4630) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL SW4630) | |
| 101YP2500X Counselor, Professional (Licence: FL SW4630) | |
| 103K00000X Behavior Analyst (Licence: FL SW4630) | |
| Enumeration Date | 2008-10-16 |
| Last Update Date | 2008-10-16 |