| NPI | 1831602283 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL MH15094) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health | 
| Enumeration Date | 2017-11-08 | 
| Last Update Date | 2017-11-08 |