| NPI | 1639492036 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder (Licence: UT 347866-6004) |
| Enumeration Date | 2010-03-12 |
| Last Update Date | 2024-03-20 |