| NPI | 1619371507 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NV 101ya0400x) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: NV 103k000000x) |
| Enumeration Date | 2014-10-21 |
| Last Update Date | 2014-10-21 |