| NPI | 1760686489 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA CCS #15096) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: CA CATC IV 101963) |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2017-03-23 |