| NPI | 1811254089 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: FL SW14675) |
| 101YM0800X Counselor Mental Health | |
| Enumeration Date | 2012-04-12 |
| Last Update Date | 2022-03-23 |