| NPI | 1790969061 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH9163) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO ACC3214) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL 3236) | |
| 101YM0800X Counselor, Mental Health (Licence: CO 1985) | |
| Enumeration Date | 2007-12-21 |
| Last Update Date | 2011-11-23 |