| NPI | 1659552651 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC005074) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VA MAC 508018) |
| 101YM0800X Counselor, Mental Health (Licence: NC NCC 236587) | |
| 101YS0200X Counselor, School (Licence: GA SRS P12 683283) | |
| 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children (Licence: 508018) | |
| Enumeration Date | 2007-11-18 |
| Last Update Date | 2019-07-29 |