| NPI | 1649676883 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: PA 8315) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: PA CW023841) |
| 104100000X Social Worker (Licence: PA CW023841) | |
| 324500000X Substance Abuse Rehabilitation Facility (Licence: PA 467133) | |
| Enumeration Date | 2014-11-17 |
| Last Update Date | 2024-06-19 |