| NPI | 1700807971 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: KS 12573) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: KS 1893) |
| 1041C0700X Social Worker Clinical (Licence: KS KS1893) | |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2007-07-08 |