| NPI | 1609897255 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VT 000279) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: VT 089-0000449) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2007-07-09 |