| NPI | 1720239650 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI 6401008526) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: MI 6401008526) |
| Enumeration Date | 2008-10-09 |
| Last Update Date | 2008-10-09 |