| NPI | 1851698534 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NE 936) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NE 884) |
| 101YP2500X Counselor Professional (Licence: NE 1927) | |
| Enumeration Date | 2011-02-16 |
| Last Update Date | 2012-06-21 |