| NPI | 1659711828 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: GA MFT001058) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: GA 1801-R) |
| Enumeration Date | 2013-07-02 |
| Last Update Date | 2013-07-02 |