| NPI | 1578653598 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NC CCS 231) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NC 182) |
| 101YM0800X Counselor Mental Health (Licence: NC LPC 912) | |
| 101YM0800X Counselor Mental Health (Licence: NC NBCC 35874) | |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2013-07-23 |