| NPI | 1730397225 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL CAP1406) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: FL PY7080) |
| 106H00000X Marriage & Family Therapist (Licence: FL MT1504) | |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2007-07-08 |