| NPI | 1598797052 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IA ACADC 93029) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IA LMHC 00093) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2007-07-08 |