NPI | 1609268903 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180.009485) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 30482) |
101YM0800X Counselor, Mental Health (Licence: IL 180.009485) | |
Enumeration Date | 2015-02-23 |
Last Update Date | 2015-03-12 |