| NPI | 1669501326 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI 2-00738) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MI 6401004533) |
| 1041C0700X Social Worker, Clinical (Licence: MI 6801059235) | |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2007-07-08 |