| NPI | 1588860365 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: SC 4864) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: SC 336) |
| 101YP2500X Counselor, Professional (Licence: NC 6631) | |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2022-06-21 |