| NPI | 1629210117 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: PA PC002462) | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: PA CCDP-D 6206) | 
| 101YM0800X Counselor, Mental Health (Licence: PA ATR-BC 85-062) | |
| Enumeration Date | 2009-03-30 | 
| Last Update Date | 2009-03-30 |