| NPI | 1750443917 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: NM I-04800) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NM 4097) |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2009-12-11 |