| NPI | 1770612178 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: NC 2219) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: NC 091) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NC 1172) | |
| Enumeration Date | 2007-03-04 |
| Last Update Date | 2010-08-05 |