| NPI | 1811291099 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YS0200X Counselor, School (Licence: LA A046503) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: LA LAC#653) |
| Enumeration Date | 2011-01-03 |
| Last Update Date | 2011-01-03 |