| NPI | 1710271101 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: CT 003267) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CT 000815) |
| Enumeration Date | 2011-06-03 |
| Last Update Date | 2018-04-02 |