| NPI | 1710293303 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MD LC2671) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MD LC2671) |
| 101YP2500X Counselor Professional (Licence: MD LC2671) | |
| Enumeration Date | 2010-08-20 |
| Last Update Date | 2010-08-20 |