| NPI | 1588613673 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: LA 890) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: LA 2015) |
| 106H00000X Marriage & Family Therapist (Licence: LA 458) | |
| Enumeration Date | 2006-05-08 |
| Last Update Date | 2007-07-08 |