| NPI | 1740491935 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NJ 37LX00115000) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: PA 2514) |
| 101YM0800X Counselor, Mental Health (Licence: PA PC001522) | |
| Enumeration Date | 2007-05-27 |
| Last Update Date | 2007-07-08 |