| NPI | 1750739694 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 17-03-08) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OR R4284) |
| Enumeration Date | 2016-06-01 |
| Last Update Date | 2017-05-01 |