| NPI | 1679924609 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL ADC-011530-2015) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL IMH 6973) |
| Enumeration Date | 2016-06-30 |
| Last Update Date | 2016-07-01 |