| NPI | 1649782947 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: AK 106412) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: AK 106412) |
| Enumeration Date | 2017-10-26 |
| Last Update Date | 2017-10-26 |