| NPI | 1679945083 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: SC 4675) |
| Enumeration Date | 2015-10-24 |
| Last Update Date | 2017-12-04 |