| NPI | 1578866802 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: PA 008222) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: PA CADC- 9078) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NY CASAC -13295) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NY 13295) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VT 000466) | |
| 101YP2500X Counselor, Professional (Licence: PA pc008222) | |
| Enumeration Date | 2010-12-08 |
| Last Update Date | 2024-02-06 |