| NPI | 1790272631 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NJ 37LC00271800) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: PA PC010290) |
| Enumeration Date | 2018-04-17 |
| Last Update Date | 2018-04-17 |