| NPI | 1801834239 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MA 389) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: VT 068-0000146) |
| 106H00000X Marriage & Family Therapist (Licence: VT 100-0000035) | |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2007-07-08 |