| NPI | 1578090791 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MD LC7496) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MD LC7496) |
| 101YM0800X Counselor, Mental Health (Licence: MD LC7496) | |
| Enumeration Date | 2017-05-18 |
| Last Update Date | 2017-05-18 |