| NPI | 1740546225 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: SC 5482) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: SC 5473) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: SC 5267) | |
| 106H00000X Marriage & Family Therapist (Licence: SC 4599) | |
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) | |
| Enumeration Date | 2012-04-09 |
| Last Update Date | 2015-03-12 |