| NPI | 1841335270 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: GA Certification #1767R) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: GA MFT000985) |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2021-01-15 |