| NPI | 1639432511 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 246ZS0410X Specialist/Technologist, Other Surgical Technologist |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor Addiction (Substance Use Disorder) | |
| 103K00000X Behavior Analyst | |
| 104100000X Social Worker | |
| Enumeration Date | 2012-06-16 |
| Last Update Date | 2013-09-02 |