| NPI | 1790095875 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH8873) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL CAP4764) |
| Enumeration Date | 2010-10-07 |
| Last Update Date | 2010-10-07 |