| NPI | 1669604138 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WI 11413-132) |
| Enumeration Date | 2009-08-18 |
| Last Update Date | 2020-05-13 |