| NPI | 1811971096 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OR c1143) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR Cert #: 95-R-38) |
| Enumeration Date | 2005-12-01 |
| Last Update Date | 2007-07-10 |