| NPI | 1770857807 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CT CAC-4066) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CT 125312) |
| 101YP2500X Counselor, Professional (Licence: VA SAP20172) | |
| Enumeration Date | 2012-03-07 |
| Last Update Date | 2012-03-07 |