| NPI | 1831305119 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL 23187) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL 0002461) |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: FL 00773) | |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2007-07-08 |