| NPI | 1730457193 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 2526) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC 2526) |
| 101Y00000X Counselor (Licence: NC 2526) | |
| Enumeration Date | 2011-12-13 |
| Last Update Date | 2016-02-25 |