| NPI | 1710398805 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: GA 760) |
| Additional Taxonomies | 101YP1600X Counselor, Pastoral (Licence: GA 0) |
| Enumeration Date | 2014-05-12 |
| Last Update Date | 2014-05-12 |