| NPI | 1669782181 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CT 669)  | 
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CT 1843)  | 
| 106H00000X Marriage & Family Therapist (Licence: CT 1027)  | |
| Enumeration Date | 2010-10-18 | 
| Last Update Date | 2010-10-18 |