| NPI | 1639154735 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: RI MHC 00181) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: RI LCDP 00290) |
| Enumeration Date | 2005-12-12 |
| Last Update Date | 2012-02-14 |