| NPI | 1700131232 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WI 1451-226) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: WI 280-228) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 15715-132) | |
| Enumeration Date | 2012-07-20 |
| Last Update Date | 2012-11-12 |