| NPI | 1679782882 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL 2592) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH6975) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2007-08-10 |