| NPI | 1811182793 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC 6867) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 1137) |
| 101Y00000X Counselor (Licence: NC 392) | |
| Enumeration Date | 2007-09-13 |
| Last Update Date | 2013-05-03 |