| NPI | 1851665129 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL 4418) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL 120999) |
| Enumeration Date | 2012-03-03 |
| Last Update Date | 2012-03-03 |