| NPI | 1578803441 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WI 1671-226) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 17072-130) |
| Enumeration Date | 2013-02-28 |
| Last Update Date | 2014-01-14 |