| NPI | 1578811980 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WI 15709-132) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: WI 10901-120) |
| Enumeration Date | 2012-08-16 |
| Last Update Date | 2012-09-11 |