| NPI | 1699751107 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 1926) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NC 4817) |
| Enumeration Date | 2005-12-16 |
| Last Update Date | 2007-07-09 |