| NPI | 1821322330 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH12271) |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: VA 0718000229) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL CAP 2752) | |
| Enumeration Date | 2009-09-30 |
| Last Update Date | 2014-02-19 |