NPI | 1821491184 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MD LGP3291) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MD LGA2061) |
Enumeration Date | 2014-10-01 |
Last Update Date | 2014-10-01 |