| NPI | 1710298823 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CO 7085) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: CO 1434) |
| Enumeration Date | 2010-06-24 |
| Last Update Date | 2017-03-03 |