| NPI | 1720031354 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: KY 703) |
| Additional Taxonomies | 101YP2500X Counselor Professional |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2023-02-09 |