| NPI | 1750520581 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: NC Provisional) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC Provisional) |
| Enumeration Date | 2009-02-18 |
| Last Update Date | 2009-02-18 |