| NPI | 1619283512 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: DE 1111) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: DE 702897) |
| Enumeration Date | 2010-08-30 |
| Last Update Date | 2010-08-30 |