| NPI | 1679753776 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: FL 0003049) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: FL 0003049) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: 37854) | |
| Enumeration Date | 2007-11-07 |
| Last Update Date | 2007-11-07 |