| NPI | 1811360480 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL MT29790) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: FL MT29790) |
| Enumeration Date | 2015-11-04 |
| Last Update Date | 2015-11-04 |