| NPI | 1821530791 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KS 1030) |
| Additional Taxonomies | 104100000X Social Worker (Licence: KS 9822) |
| Enumeration Date | 2016-11-09 |
| Last Update Date | 2016-11-10 |