| NPI | 1659673358 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: PR 189) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: PR 1340) |
| Enumeration Date | 2010-12-01 |
| Last Update Date | 2011-11-04 |