| NPI | 1740499383 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WI 2006-132) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: WI 1524-125) |
| 1041C0700X Social Worker Clinical (Licence: WI 3358-123) | |
| 163W00000X Registered Nurse (Licence: WI 37015-030) | |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2007-07-08 |