| NPI | 1578086070 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NE P-1510) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NE 11293) |
| Enumeration Date | 2017-07-18 |
| Last Update Date | 2018-07-19 |