| NPI | 1649555400 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical |
| Enumeration Date | 2011-10-12 |
| Last Update Date | 2012-12-05 |