| NPI | 1689898264 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CT 000722) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CT 001627) |
| 103TC1900X Psychologist, Counseling (Licence: CT 001627) | |
| 101YM0800X Counselor, Mental Health (Licence: CT 001627) | |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2016-05-11 |