| NPI | 1598889024 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WI 13743-135) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 11654-132) |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2007-07-08 |