| NPI | 1598150260 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: GA 439) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: GA 083) |
| Enumeration Date | 2015-03-31 |
| Last Update Date | 2015-03-31 |