| NPI | 1689010365 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC 8446) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NC A8446) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 2525A) | |
| Enumeration Date | 2013-05-21 |
| Last Update Date | 2013-06-06 |