| NPI | 1710234059 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC LCAS-25582) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NC P006913) |
| Enumeration Date | 2012-08-06 |
| Last Update Date | 2022-01-25 |