| NPI | 1629281597 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 15245130) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2013-03-06 |