| NPI | 1598003733 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 3082-A) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC A10020) |
| 101YP2500X Counselor, Professional (Licence: NC A10020) | |
| Enumeration Date | 2013-01-23 |
| Last Update Date | 2014-03-07 |