| NPI | 1720586936 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: IN 39002286A) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: IN 87000662A) |
| Enumeration Date | 2018-01-23 |
| Last Update Date | 2018-01-23 |