| NPI | 1629011259 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NE 104) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 1578) |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2007-07-08 |