| NPI | 1730342254 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MO 002720) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MO 2442) |
| Enumeration Date | 2008-07-03 |
| Last Update Date | 2008-07-03 |