| NPI | 1588869630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL 2582) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: FL 0002531) |
| 106H00000X Marriage & Family Therapist (Licence: FL 0001357) | |
| Enumeration Date | 2007-06-19 |
| Last Update Date | 2007-07-08 |