| NPI | 1699148080 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC 12294) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC LCAS-22136) |
| 101YP2500X Counselor, Professional (Licence: NC A12294) | |
| Enumeration Date | 2015-11-06 |
| Last Update Date | 2019-03-15 |