| NPI | 1730278821 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: TX 8030) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: TX 13863) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2007-07-09 |