| NPI | 1679718704 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: IL 180008689) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: IL 178003708) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: IL 22311) | |
| Enumeration Date | 2008-12-03 |
| Last Update Date | 2013-07-02 |