NPI | 1639522527 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 16837-130) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WI 2697-226) |
Enumeration Date | 2016-07-15 |
Last Update Date | 2018-05-31 |