| 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 |