| NPI | 1699081695 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MD LCA1707) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MD LC2156) |
| Enumeration Date | 2010-08-27 |
| Last Update Date | 2010-08-27 |