| NPI | 1609201656 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI 6401006369) |
| Enumeration Date | 2013-09-10 |
| Last Update Date | 2014-08-18 |