| NPI | 1669657300 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OR c4372) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 180-006757) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 30612) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 16-r-58u) | |
| Enumeration Date | 2007-12-31 |
| Last Update Date | 2017-01-10 |