| NPI | 1588742696 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC 4052 LPC) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 460 LCAS) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 72 CCS) | |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2012-05-15 |