| NPI | 1649591553 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO LPC.0011599) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: VT 068.0066338) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO ACD.0000541) | |
| Enumeration Date | 2010-06-15 |
| Last Update Date | 2016-03-21 |