| NPI | 1669568200 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: SD 04071198) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: SD LPC1040) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2009-08-07 |