| NPI | 1841775897 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101Y00000X Counselor (Licence: NJ 37PC00639700) | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NJ 37LC00277700) | 
| Enumeration Date | 2018-09-26 | 
| Last Update Date | 2018-09-26 |