| NPI | 1659440220 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC 5538) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: SC 0501059) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: 507180) | |
| 101YP2500X Counselor, Professional (Licence: SC 4090) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: 12882) | |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2017-04-25 |