| NPI | 1689989048 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 11559-132) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: WI 326-228) |
| Enumeration Date | 2010-08-10 |
| Last Update Date | 2014-04-02 |