| NPI | 1578881421 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: LA 1647) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: LA 000024) |
| 225700000X Massage Therapist (Licence: LA 0309) | |
| Enumeration Date | 2010-05-16 |
| Last Update Date | 2019-06-11 |