| NPI | 1699815092 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: FL 0000430) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: FL MH0000430) |
| 101YM0800X Counselor Mental Health (Licence: FL MH0000430) | |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2007-07-08 |